Nosebleeds can start at the most unexpected moment and there are many reasons for this phenomenon: from the usual mechanical damage nasal vessels to more serious illnesses. Why there is blood from the nose, a specialist will help you figure out who you need to contact if the bleeding is repeated repeatedly. In any case, you should know how to stop the bleeding and what actions to take when simple methods do not help.

Bleeding from the nose(scientifically epistaxis) is a developmental anomaly in which blood flows from the vessels of the nasal cavity. The danger of such a condition may lie in large blood loss, which threatens human life and health. According to statistics, about 20% of all patients with epistaxis turn to ENT doctors for emergency assistance. In 80-85% of patients, problems with the hemostatic system are diagnosed. About 85% of cases of epistaxis are a symptom of diseases of the organs and systems of the body, and in 15% of cases the causes of the phenomenon are pathologies of the nasal cavity.

Types of nosebleeds are determined by their profusion:

1. Minor hemorrhage - a few milliliters of blood flows from one nostril. Hemorrhage can be stopped quickly with the right help. Negative moments of the state - fear, confusion, discomfort.
2. Moderate hemorrhage - about 300 ml of blood flows from the nose in adults. Consequences of profuse blood loss - lightheadedness, weakness in the body, "flies" before the eyes, thirst, rapid pulse, blanching of the skin, shortness of breath, hum in the ears.
3. Profuse (massive, severe) bleeding is dangerous for humans. Blood loss can be more than 300 ml. Medicine recorded cases when the volume of blood flowing from the nose was more than a liter. The consequence of the condition can be hemorrhagic shock, accompanied by loss of consciousness, a significant decrease in blood pressure, insufficient blood circulation in the organs.

Nosebleeds are classified as front(blood comes out through the nostrils) and rear(blood descends down the back wall of the nasopharynx). Anterior hemorrhage is rarely abundant, the life and health of the victim is not threatened, it can be stopped on its own. back bleeding characterized by excessive profusion, can only be stopped with the help of doctors.

Causes of nasal hemorrhage

Nosebleeds can go for many reasons, which are divided into general and local.

Nosebleeds in adults may be due to external factors. These include:

1. Staying in dry air. Due to the constant inhalation of dry air, the nasal mucosa dries up and sticks together with small vessels, which in turn also become weak and brittle.
2. Long-term use of certain groups of medicines: corticosteroids, antihistamines, vasoconstrictor drops, blood thinners.
3. Overheating of the body, sun or heat stroke. The condition is usually accompanied by weakness, dizziness, nausea, fainting. There is a buzzing in the ears.
4. Strong sneezing or coughing, as a result of which the pressure in the vessels of the nose increases sharply.
5. Intoxication of the body through inhalation harmful vapors, gases, aerosol agents, thermal, electrical and chemical burns of the mucous membrane, prolonged exposure to radiation on the body.
6. pressure drops in the atmosphere.
7. Serious physical activity.

Causes of frequent nosebleeds

To answer why nosebleeds often come out is within the power of a doctor who has fully examined the patient. The reason for regular epistaxis is the peculiarity of the structure of the cavity of the olfactory organ. Regular scanty bleeding from the nose when sneezing, coughing or rhinitis speaks of the fragility of the vessels of the Kisselbach plexus. Nasal bleeding during ozen (aka atrophic rhinitis) often occurs due to drying of the mucous membrane and blood vessels that burst and bleed.

Frequent epistaxis is observed with hormonal instability. Especially dangerous phenomenon It is considered for pregnant women who undergo a serious restructuring of the body during this period. Due to the increase in the level of sex hormones, the blood supply to the vessels of the whole organism increases. And if a woman has weak, fragile blood vessels, she may experience frequent nosebleeds. In pregnant women, this symptom indicates an increased blood pressure, kidney or liver problems.

There are always reasons for nosebleeds. Determine what exactly caused the bleeding, will help full examination organism. Based on the results of tests and studies, the attending physician will select best method treatment. In any case, if nosebleeds began without a reason, you should be examined in the clinic - self-medication can be fatal.

The first signs of previous bleeding. How to recognize?

To recognize whether the blood comes from the nose or not is not so difficult. The main thing to pay attention to characteristics nasal bleeding:

1. Harbingers: dizziness, burning and discomfort in the nose, buzzing in the ears, headache, pale skin, increased blood pressure, increased heart rate, shortness of breath.
2. As a rule, blood runs from the nose not foamy, but homogeneous. If it bubbles and foams, then the origin of bleeding is pulmonary.
3. With epistaxis, the blood is dark red, with pulmonary bleeding it is bright scarlet, and with gastric bleeding it is dark, closer to coffee color, with a thick consistency.
4. If blood flows along the back wall of the nasopharynx, then the patient may experience vomiting with an admixture of dark blood.

During the examination, the doctor will accurately determine the origin of nosebleeds and what their cause is. To make a diagnosis, you will need to undergo pharyngoscopy, ultrasound internal organs, make a coagulogram, ECG, EEG, echocardiography, radiograph of the nasopharynx, MRI of the nasopharynx, general analysis of urine, blood.

How to stop epistaxis? First aid for bleeding

If an adult or elderly person has a nosebleed, follow these steps:

1. First aid is to stop the bleeding. First you need to calm down, seat the victim on a chair, slightly tilt his head forward.
2. In order for air to freely enter the lungs of the victim, one should unbutton his belt, the top buttons of his shirt, untie his tie (if epistaxis is observed in men), unbutton his bra, remove jewelry (if women are bleeding from the nose).
3. Should be placed on the bridge cold compress(ice from the freezer wrapped in a napkin). Keep the compress for 10 minutes.
4. If blood has descended into the nasopharynx, it must be spit out.
5. With weak bleeding, you can pinch the nostrils at the wings of the nose with your fingers for 5-7 minutes. If there is an assistant who will clamp the victim's nostrils, the patient can stretch two hands up if epistaxis is observed from two nostrils, or one corresponding to a bleeding nasal passage. Thus, the blood flow in the organ slows down, and the resulting blood clot clogs the vessel.
6. With significant bleeding in the nostrils, you can drip 3% peroxide or any drug with a vasoconstrictor effect.
7. If the blood continues to flow, then the peroxide is applied to a cotton swab and injected into the nasal passage, gently pressing against the central wall of the nose.
8. If the nose bleeds unexpectedly due to overheating, then the victim must be taken to a cool place and an ice compress applied to the nose. The victim will need hospitalization.
9. If the patient is unconscious, you should lay him on his back, take his head to the side. Then call an ambulance.
10. If in 15-20 minutes first aid does not give positive results need to go to the clinic.

If measures to stop nasal hemorrhage have been successful and the victim feels well, he should be given sweet tea to drink and taken to fresh air.

How can and how not to do with bleeding?

What is forbidden to do?

1. Tilt your head back - blood can go down the esophagus, causing vomiting reflex; provoke suffocation.
2. You should not blow out the blood from the nose: the consequence of rash actions is severe bleeding.
3. You can not remove the swab from the nostrils with a sharp movement - it should first be soaked with peroxide.
4. You can not lean forward strongly - hemorrhage from this intensifies.
5. It is not recommended to lie down horizontally and hold your head straight - it is better to turn it to the side.
6. If the reason why blood is pouring from the nose is a foreign object, you do not need to try to get it yourself.

When to see a doctor?

You need to seek medical help if:

• there is a profuse loss of blood (from 200 ml);
• there is an injury to the nose or skull;
• if the nosebleed suddenly started does not stop even after the measures taken to stop it;
• exacerbation of chronic diseases;
• diagnosed with acute viral infections;
• the general state of health of the patient worsened;
• the victim has high blood pressure, diabetes;
• symptoms include vomiting blood.

Therapy for nosebleeds

Treatment methods for pathology consist of three principles: rapid relief of bleeding, drug therapy aimed at reducing blood loss, the impact on the cause of the problem.

1. Medical treatment. If the patient bleeds from the nose and this phenomenon is repeated, he may be prescribed vasoconstrictive, hemostatic, blood clotting, blood pressure lowering drugs.
2. Cauterization of the nasal mucosa. It is used if the factor why blood drips from the nose is the small vessels of the anterior wall of the organ.
3. Oxygen therapy is oxygen therapy.
4. Tamponade - is carried out in a hospital exclusively by the attending physician. Tamponade of the nasal cavity is distinguished as anterior and posterior. The procedure is performed with gauze swabs or a hemostatic sponge.
5. Surgical methods. With weak bleeding, the surgeon can inject novocaine (0.5%) or quinine dihydrochloride (0.5-1%) under the mucosa, remove the submucosa of the nasal septum, and scrape out vascular growths. If the blood flows constantly through the nose, ligation of the vessels is performed, with a recurrent problem, nasal dermoplasty is performed (the mucous membranes of the anterior part of the nasal cavity are excised and replaced with a skin flap taken from the patient's behind the ear area).

There are many reasons why nose bleeds. And this may not be a one-time occurrence, but constant problem, the origin of which must be clarified in without fail to exclude serious pathologies.

Nosebleeds are a fairly common condition that complicates the course of many diseases. Its manifestations and consequences have a wide range. The root cause of this pathology are allergic, traumatic injuries nose or underlying disease. In some cases, nosebleeds can also occur in a practically healthy person (for example, after severe overwork, prolonged exposure to the sun or frost). Under such conditions, the mucous membrane dries up, which is why small blood vessels are injured. usually here health care is not required, as the outflow of blood from the nose stops on its own.

Nose bleed

The discharge of blood from the nose (epistaxis) in some patients begins suddenly, while in others it is preceded by prodromal phenomena:

• Dizziness.
• Headache.
• Tickling or itching in the nose.
• Noise in ears.

You need to know that blood in the nose can get from other parts of the upper respiratory tract: lungs, larynx, pharynx, trachea, and sometimes through auditory tube from the middle ear. You can recognize this by examining the ENT organs.

Bleeding from the nose

There are severe (strong), moderate and minor nosebleeds.

1. Severe nosebleed poses a threat to life. It occurs with severe facial injuries. It is characterized not only by intensity, but also by relapses after a while. During the day, blood loss ranges from 200 ml to 1 liter or more. In this case, a person has a sharp general weakness, sweating, a drop in blood pressure.
2. At moderate nosebleeds blood will stand out from a few tens to 200 ml in an adult. Hemodynamics is usually within the physiological norm. In debilitated adults and children, external excretion blood secretions often does not give a complete picture of the real blood loss, since part of the blood is swallowed, flowing into the throat.
3. At minor bleeding blood is secreted in drops for a short time. Its volume is a few milliliters. Frequently recurring, long recurring, albeit seemingly harmless, nasal discharge can adversely affect a developing young organism. They require radical treatment.

Causes of nosebleeds

The nasal mucosa is actively supplied with blood. And frequent nosebleeds are initial signs severe pathological processes in the body. Causes of nosebleeds are divided into local and general.

General:

• Loss of elasticity of blood vessels and their fragility are associated with diseases that are associated with hormonal regulation(ovarian dysfunction, diabetes mellitus, etc.) Also spontaneous bleeding from the nose signal a serious illness - emphysema. It represents the inability of the affected areas to a normal supply of oxygen. With this pathology, blood, rushing into the upper parts of the respiratory tract, creates a high load on the venous walls.
• If headache, tinnitus, weakness appear before bleeding, then it can be assumed that it is associated with an increase in blood pressure. At hypertension the appearance of blood streams from the nose serves as a compensatory mechanism that does not allow overloading the vessels of the brain. However, intense bleeding can lead to a rapid drop in blood pressure and collapse.
• leukemia, severe illness blood, malignant tumors in bone marrow can cause frequent nosebleeds. Nosebleeds cause pressure surges. This can provoke diseases of the kidneys and liver, which are destructive in nature: nephrosclerosis, nephrosis, cirrhosis of the liver.
• Often, nosebleeds appear due to changes in hormonal levels (during adolescence, during pregnancy).
• However, nosebleeds are not always caused by serious illnesses. For example, their appearance stimulates the excessive use of drugs that act on the receptors of the mucous membranes (nazivin, otrivin, oxymetazoline). The mechanism of their action is that they reduce the release of exudate and block irritation. Therefore, their frequent use leads to fragility of blood vessels and dryness of the mucosa.

Local:

• Among local factors highlight features anatomical structure. The release of blood during a runny nose, coughing, sneezing suggests that the walls of the vessels of the Kisselbach plexus are weak. Such nosebleeds appear, as a rule, from childhood.
• The cause of bleeding from the nose are mucosal polyps or angioma. These diseases require immediate appeal see a doctor, as in some cases they can be malignant. Injuries are also a factor that contributes to changes in the structure of the vessels of the nasal septum. They can lead to neoplasms.
• Atrophic rhinitis can lead to spontaneous bleeding from the nose. With this disease, the mucous membrane dries up, becomes thinner. This leads to the fact that the vessels are damaged even with minor touches.

Frequent nosebleeds

In adults, frequent nosebleeds are associated with factors such as:

• Diseases of the blood, spleen, liver.
• bacterial infections.
• Excessive mental and physical stress.
• Prolonged exposure to the sun.
• Lack of vitamins (particularly vitamin C).

In older people:

• Atherosclerosis.
• Increased blood pressure.
• Thinning of the walls of blood vessels.

For people of any age:

• Deviation of the nasal septum.
• Severe cough, runny nose, sneezing.
• Excessive dryness of the air.
• Dustiness of the premises.
• Allergic reactions.

AT early age development features respiratory system cause such a fact that in children, bleeding from the nose is not always caused by pathological conditions. Most often, nosebleeds in children occur due to damage to the nasal mucosa by mechanical means:

• Trauma.
• bruised.
• Fall damage.
• Introduction of small foreign objects into the nose.

If a child has mucus with thick blood clots along with blood from the nose, it means that an inflammatory process (sinusitis, rhinitis, etc.) occurs in his nasal cavity, this condition requires additional treatment.

Prolonged and persistent nosebleeds in children, which are combined with the occurrence of bruises and bruises, may indicate hemophilia and a violation of blood clotting processes.

Nosebleed in a child

Often, the general weakness of the immune system leads to the fact that the nose bleeds in a child. One reason is hypovitaminosis. With a lack of vitamins C and A in the body, the walls of blood vessels become fragile and brittle, and the slightest physical activity can cause an increase in pressure, resulting in rupture of blood vessels and nosebleeds.

Dry indoor air thins the mucous membrane. If in the room where the child is, you often use heaters and ventilate him little, he may start bleeding from the nose.

Chronic runny nose causes fragility and fragility of the vessels of the nose. If a child is often sick with acute respiratory infections, nosebleeds are also possible.

At endocrine disorders and vegetative-vascular dystonia in children, blood pressure rises, which is a potential cause of bleeding from the nose.

The victim should be given the following assistance for nosebleeds:

• Monitor the general condition and carry out first aid measures for bleeding.
• When the bleeding stops, lubricate the nasal mucosa with vaseline oil.
• Increase air humidity (using a humidifier or wet sheets).
• Subsequently, it is good to instill preparations based on sea ​​water(saline, aquamaris).

How to stop nosebleeds

There are many ways to stop nosebleeds. Depending on the reasons that caused it, as well as the individual characteristics of the body, apply different ways treatment. The main thing is not to make mistakes:

• It is not recommended to tilt your head back, as blood (along the back of the nose) will drain into the throat. This can lead to the fact that (if it enters the respiratory tract) you can suffocate or swallow it until you vomit. For the same reason, you can not go to bed. Keep your head upright or slightly tilted forward.
• Secondly, do not forget to blow your nose, because blood clots do not allow the vessels of the nose to contract.
• You need to slow down the blood flow by applying ice to the bridge of your nose.

Can be instilled into the nose vasoconstrictor drugs(solution of ephedrine, galazolin), take 100 - 200 mg of ascorbic acid and heart drops.

First aid for nosebleeds

First aid for nosebleeds and should be provided as soon as possible. To do this, you need to know the basic methods of its provision:

• Have the patient sit down with the torso slightly leaning forward.
• If there are no signs of a nose fracture, then you can slightly press the wings of the nose against the nasal septum with the index and thumbs(for 3 - 5 minutes). At the same time, ask the victim to tilt his head slightly forward and breathe through his mouth.
• Soak a cotton swab in 3% cold water or hydrogen peroxide. Insert a swab into the nostril (bleeding) and pinch it with your fingers. Put a piece of cloth soaked in cold water or an ice pack on the nose. Stay in this position for 10-20 minutes.
• To make sure that bleeding does not continue into the nasopharynx, you need to look into the patient's mouth, ask him to spit out saliva and make sure that there is no blood in it. After carefully remove the swab (after moistening it with cold water with a pipette.)

Important: the victim should not be laid horizontally and his head thrown back. Blood, if it enters the nasopharynx, can cause vomiting.

If, despite all efforts, the blood cannot be stopped, you need to call as soon as possible. ambulance.

Treatment of nosebleeds

The treatment of nosebleeds is to stop the bleeding as soon as possible, as well as to compensate for blood loss or to take therapeutic measures to combat the underlying disease.

In case of anterior nosebleed, to stop the blood, you need to put cold on the nose for 15 minutes, press the nostril or insert a swab soaked in a hemostatic agent into the nasal cavity. Also, an anemization of the nasal mucosa is done with a solution of ephedrine or adrenaline. If the bleeding does not stop within 15 minutes, nasal tamponade is done.

If the above measures are ineffective - carry out surgical treatment. The tactics and scope of the operation is determined by localizing the source of bleeding. If nosebleeds recur and are localized in the anterior parts of the nose, then apply:

• Cryodestruction (freezing with liquid nitrogen).
• Endoscopic coagulation.
• The introduction of sclerosing drugs.
• Other measures that are aimed at obliterating the lumen of the vessels of the Kisselbach zone.

Treating nosebleeds at home

1. At frequent nosebleeds take a small iron key, hang it on a woolen thread (on a woolen one) around your neck so that the key is on your back between your shoulder blades. The nosebleed will stop immediately.
2. 1/3 st. l. alum powder (in pharmacies) dissolve in a glass of water and this solution rinse your nose when bleeding. The blood stops quickly, attacks become less frequent, and then completely disappear.
3. With frequent nosebleeds for 10-15 days, eat a piece of aloe tree leaf 2 cm long before eating. If blood comes from the right nostril, raise the right hand up above the head, and hold the nostril with the left and vice versa.
4. Put cotton wool moistened with fresh nettle juice into the nose. 10-15 minutes will be enough for the bleeding to stop. The next day, the procedure can be repeated.
5. Traditional medicine recommends that for nosebleeds, soak a cotton swab in alcohol and put it on the bridge of the nose, a bone, cover it with a cloth on top. It will pinch your eyes, nothing, close your eyes and be patient. Lie down for 5-10 minutes. If bleeding continues a month or two after this procedure, although it should not, repeat again.
6. At very severe nosebleeds pour half a bucket of cold water on the patient’s head (conveniently from a watering can), and pour half a bucket on upper part back.

With timely assistance, nosebleeds are not dangerous. In some cases (with an increase in blood pressure), it can lower it, thereby preventing cerebral hemorrhage. However, if the bleeding is threatening, it must be stopped immediately.

Repeated nosebleeds give rise to suspicion common disease and require hospitalization. In such cases, only classical methods treatment.

But, fortunately, in most cases, means can help. traditional medicine, the recipes of which are given in our article.

Nasal bleeding is a pathological condition that can occur for various reasons in humans. different ages. The most common factor that leads to nosebleeds is high blood pressure.

Often, everything ends well for the patient, without contacting the ambulance team, but under certain conditions, the intervention of a doctor is indispensable.

The main causes of nosebleeds - symptoms of which diseases can be nosebleeds?

The phenomenon under consideration can occur spontaneously, regardless of certain diseases.

There are several factors that can cause this condition:

• Stay in direct sunlight long time.
• Stressful state.
• Excessive consumption of alcoholic beverages. Alcohol favors the expansion of blood vessels, which affects the permeability of their walls.
• Negative reaction of the body to certain medications.
• Hormonal disruption in the body due to age-related changes(in adolescents), as well as during pregnancy.

Nosebleeds can be a specific pathology of some professions that are associated with changes in atmospheric pressure.

This risk group includes pilots, climbers, etc.

To local reasons that can cause nosebleeds include:

• Injury to the nose from the outside, or from the mucosa.
• Pathological neoplasms in the nasal cavity / sinuses, at the base of the skull.
• Fracture of the skull. In such incidents, the nose may also leak cerebrospinal fluid that is white in color.
• Violation of the integrity of the internal carotid artery by fragments of the bones of the skull.
• Inflammatory phenomena in the adenoids, sinusitis.
• Dystrophic changes in the nasal mucosa. Such transformations can occur against the background of atrophic rhinitis or.

Nosebleeds often develop against the background of a number of diseases, the main of which are:

1. Work failures of cardio-vascular system: hypertension, atherosclerosis of blood vessels, various pathologies hearts.
2. Pathologies associated with the ability of blood to clot: platelet deficiency (thrombocytopenia), hemophilia, blood cancer, anemia. The lack of hemoglobin, a certain vitamin group, causes blood thinning, and this negatively affects its coagulation. This group also includes Randu-Osler syndrome - congenital pathology vessels.
3. Serious defects in the functioning of the spleen, liver, kidneys.
4. Vegetovascular dystonia.
5. Infection of the body, which is accompanied by an increase in body temperature and intoxication: influenza, SARS, scarlet fever, sepsis. Under the influence of harmful microorganisms, the walls of blood vessels become thin and fragile: they are able to pass blood components, which prevent its rapid clotting.
6. Pathology of the thyroid gland.

Types of nosebleeds according to medical classification

Based on localization, nosebleeds are of two types:

1. front. Do not lead to significant blood loss, and often they can be easily eliminated without medical intervention. The source of the considered type of bleeding from the nose is the Kisselbach area, in which small blood vessels are concentrated.
2. Rear. Such bleeding occurs due to rupture of the walls large vessels, which are located deep in the mucous layers of the nasal cavity. These bleedings cannot be stopped on their own: the help of a doctor is required. Otherwise, significant blood loss may occur.

Depending on the amount of blood lost, these bleedings are divided into three groups:

• mild severity. Compared with the other two types of nosebleeds, this group is very common. The blood in this case flows out in small drops, and it can be stopped by pressing the wings of the nose. Such bleeding does not pose any danger to life, however, if it lasts for a long period of time, the patient will complain of loss of strength, slight dizziness.
• Moderate (moderate) nosebleeds. Due to considerable volumes of blood loss (300 ml), the patient's systolic blood pressure decreases to 90-95 mm, the heart rate increases, the skin turns pale.
• heavy bleeding. The amount of blood lost can exceed 1 liter, and if not provided on time qualified assistance the patient may die. General state the patient deteriorates sharply: systolic pressure drops to 80 mm, heart rate increases (up to 120 beats per minute), loss of consciousness, nausea, and vomiting are possible. A blood test confirms a decrease in hemoglobin levels.

What to do with a nosebleed in an adult or a child, how to stop the bleeding - first aid and actions for bleeding

When opening a nosebleed, do the following:

1. The victim needs, first of all, to calm down. To do this, you should monitor your breathing: it should be deep and slow. This will help minimize psycho-emotional stress and lower your heart rate.
2. Monitor the correct position of the patient's body. It's better if he sits. However, in the absence of such an opportunity, it is necessary to slightly raise the head, but not tip it back. Severe tilting of the head can lead to blood entering the stomach or respiratory tract. Similar phenomena can provoke respectively vomiting or failures in breath. In addition, it is better if the blood drains into a certain container: this will help determine the amount of blood loss.

To stop mild bleeding from the nose, resort to the following measures:

• With your fingertips, you should press the wings of the nose to the bridge of the nose. This ensures mechanical compression of the blood vessels.
• Drip the nasal cavity with drops that contribute to vasoconstriction (pharmazolin, naphthyzine, etc.). Before this manipulation, the victim must blow his nose to get rid of blood clots formed in the nasal cavity.
• Drip nose with 3% hydrogen peroxide solution. With a weak blood flow, a blood clot forms quickly enough and the bleeding stops.

In case of injury to the nose, the first aid algorithm is as follows:

1. Cold should be applied to the damaged area: this will help narrow the blood vessels. A similar effect will be achieved if you put your hands in cold water. When using ice, take small breaks every 10 minutes to avoid frostbite.
2. Dip your feet into the basin warm water. Such a manipulation will provoke the expansion of blood vessels in this part of the body, providing blood flow to lower limbs and unloading of the vessels of the nasal cavity.

If it was possible to stop the bleeding, in any case, the patient should consult a doctor in order to examine the condition of the nasal bones on an X-ray machine.

In the absence of effectiveness from the use of the above methods of stopping bleeding, as well as in case of severe nosebleeds, it is necessary to make gauze turunda.

Before the introduction, it must be moistened abundantly in hydrogen peroxide or aminocaproic acid.

Since this process is very painful, the victim can pre-lubricate both halves of the nose Lidocaine.

Nose bleed(epistaxis, epistaxis) is bleeding that occurs with vascular disorders in the nasal cavity, paranasal sinuses, nasopharynx, as well as with pathology of intracranial vessels and plexuses. Among spontaneous, spontaneous bleeding of the upper respiratory tract, nosebleeds occupy the first place. In 60% of people (mostly men), these conditions can be observed at an early age (before 12 years) and older than 55 years. Often the causes of these pathological processes are injuries, as well as some "vascular syndromes" and various diseases. There are also so-called "signal" bleeding. They are characterized by a sudden onset, a short duration and a fairly large amount of blood loss.

According to the localization of the process, nasal bleeding is:

• front;
• back.

Due to the occurrence:

• local;
• general, associated with other pathological processes;
• post-traumatic.

Causes of bleeding

Very often, such bleeding is the result of the anatomical structure and location of the vessels supplying the anterior parts of the nose and septum. It is here that the Kisselbach-Little zone is located, where the superficial vascular bundle lies. A careless touch can be enough to cause bleeding in this area. Often this happens with an increase in pressure.

Malignant or benign tumors located in the nasal cavity, often cause nosebleeds. To benign formations include septal polyps, papillomas, angiomas and other formations.

Abundant and pronounced nasal bleeding complements the clinic of juvenile angiofibroma of the nasopharynx. This formation usually appears in very young and young men (12-25 years old). Bleeding is sudden and occurs mainly at night.

In cancerous tumors, bleeding is visually similar to sanious secretion having a sharp, fetid odor.

Sometimes, when examined by an ENT doctor, a bleeding polyp is found in the anterior parts of the nose, which periodically and suddenly can be manifested by the expiration of not a large number blood.

In the cold season frequent occasion for bleeding, the air becomes too dry in residential and public spaces. Under such conditions, crusts easily form on the nasal mucosa. During their removal, thin walls small vessels are damaged and subsequently begin to bleed.

Microtrauma of the mucosa can also cause minor bleeding. They appear under the influence of microscopic dust particles, aggressive gases, against the background of atrophic processes and age-related changes.

Causes of nasal general bleeding

Heart defects, cirrhosis of the liver, diseases of the kidneys, hematopoietic organs, occupational intoxication, pulmonary emphysema, beriberi, hemorrhagic diathesis, allergies are the most likely causes of frequent nosebleeds in women and men who have general character occurrence. Such bleeding is very dangerous, since they almost always occur with significant blood loss. Often they recur and cause further signs of anemia. In patients with cirrhosis of the liver, bleeding is difficult to stop. They are an early symptom of this serious disease.

Most severe bleeding of this group are found against the background of diathesis of hemorrhagic genesis. These diseases include thrombosthenia, hemophilia, hemorrhagic vasculitis, Rendu-Osler disease, Werlhof syndrome. In addition, profuse nosebleeds very often indicate a history of serious diseases of the hematopoietic organs and the spleen.

A special place is occupied by vicarious bleeding. They can come instead of missing menstruation. This is observed in amenorrhea (absence of menstruation) and hypomenstrual syndrome ( scanty menstruation), more often in adolescence in girls or in young girls.

Many acute infections flowing at high temperatures. These include influenza, scarlet fever, malaria, smallpox, typhoid and relapsing fever, etc.

Causes of traumatic bleeding

Bruises contribute to the appearance of injuries, implantation foreign body, fractures of the bones of the nose, face and skull. Long stay a foreign body causes the formation of a large number of granulations on the mucous membrane, which in the future cause bleeding. Minor injuries include scratches and abrasions that occur when dry crusts are torn off from the mucosa. In most cases, crusts form with atrophic forms of rhinitis. The risk of profuse nosebleeds occurs with fractures of the facial bones and bones of the skull. In these situations, immediate hospitalization is necessary.

Almost always, surgical operations such as rhinoplasty, septoplasty, any medical diagnostic examinations and manipulations (for example, endoscopy, probing, catheterization, punctures) end with short-term and mild nasal bleeding.

Signs of nosebleeds

The symptoms of these processes are varied and depend on the localization.

• Anterior epistaxis is manifested by the outflow of a jet from one half of the nose or from two at the same time. Such bleeding begins spontaneously, without previous factors, more often happens at night. Sometimes before its onset, weakness and dizziness are felt. The blood is bright red, without clots. This bleeding may stop on its own.
• The posterior usually begins without obvious severe symptoms and often determined after some time. With this localization of the source of bleeding, blood flows into abdominal cavity through the pharynx along its back wall. This process usually occurs with hemoptysis, hematemesis, later appearing "black" bloody stools. Symptoms of a continuing condition are marked pallor of the skin, increasing weakness, the appearance of a "threaded" pulse, and even the onset of fainting. In this situation, immediate medical attention is needed.

Diagnosis of nosebleeds

Proper diagnosis helps to localize the process, find out its cause and choose the best method of treatment. Such events are held only in the office of an otorhinolaryngologist and usually consist of several stages.

Analysis of the anamnesis and complaints of the patient:

• when did the first complaints appear?
• Was there a nose injury?
• Do you have a history of comorbidities?

General inspection includes:

• determination of the condition of the skin and mucous membranes;
• measurement of pulse rate and pressure indicators.

Rhinoscopy:

• examination of the nose area and localization of the local process;
• determines whether blood flows from one nostril or through both nasal passages;

Pharyngoscopy:

• evaluates the condition of the mucous surface of the pharynx;

Blood test:

• reflects the volume of blood loss and the work of the blood coagulation system;
• the amount of iron in the serum helps to assess the degree of possible anemia.

Treatment of nosebleeds

Different ways to stop bleeding and prevent the development of possible recurrences - this is the tactic for treating nasal bleeding. Prevention of relapses is associated with the treatment of diseases against which they can occur.

Ways to stop depend on the location and severity of the process. Epistaxis from the anterior section can be stopped on its own. To do this, it is enough to slightly press the corresponding wing of the nose against the septum, and later insert a swab with a hemostatic agent. And yet, despite the mostly favorable outcomes, with nosebleeds, it is necessary to contact an otorhinolaryngologist. This is especially important when relapses and severe blood loss are observed.

Stopping a nosebleed can be done in several ways:

• Mechanical involves anterior or posterior tamponing, during which hemostatic sponges or cartridges are installed in the nasal passages;
• Chemical shutdown is performed using a variety of chemical materials;
• The physical method involves local action different temperatures, as well as sealing of vessels with the help of an electrocoagulator;
• Pharmacological stop is carried out by the appointment medicines that improve blood clotting;
• Operational, surgical method indicated for recurrent and severe processes with severe blood loss. It can be carried out by cutting, ligating the artery and vessels, as well as using embolization.
• Mixed combines all possible options.

First aid for epistaxis

At the moment of an unexpected start of bleeding, you should pull yourself together and calm down. Excessive excitement, panic cause an increase in pressure and an increase in the intensity of blood loss. It is important to take a vertical position, lower your head a little forward - so a stream or drops of blood will freely flow down from the nasal cavity. You never need to throw your head back, in this position the blood will drain into the esophagus along the back of the throat. This will cause nausea, vomiting, and even blood entering the bronchi. If possible, it is advisable to put an ice pack on the nose area, and the feet, on the contrary, should be warm. This redistribution of temperature helps to reduce blood circulation in the nasal cavity and reduce bleeding. It is advisable to continue to breathe through the nose, the air helps blood clotting. The wing of the nose should be kept firmly pressed against the septum. To prevent bleeding from recurring, do not blow away the resulting blood clots. After a while, you should carefully sanitize the nose. However, helping with nosebleeds of a profuse and recurrent nature is best done by an experienced specialist.

Complications

The consequences of the considered pathology depend on its frequency and severity. It was previously mentioned that light and minor bleeding can stop spontaneously. They are not a danger to human life. But abundant and repetitive, can end sadly and lead to serious phenomena of hemorrhagic shock. It is manifested by lethargy, a sharp drop in blood pressure, a weak, barely perceptible pulse. This state of affairs is the reason for immediate call ambulance.

Prevention of nosebleeds

Preventive measures depend on the etiology of the disease. People suffering from frequent epistaxis should first of all know the reasons for their appearance. Are they related to the rise in pressure or not? Is there a history of a general medical condition associated with nasal bleeding? Were there any injuries to the nasal mucosa?

To prevent bleeding, excessive physical activity. It is necessary to eat properly and balanced, drink enough liquid per day. Do not allow the air to dry out in apartments and work areas; if possible, use humidifiers and air ionizers. It is very important to treat promptly acute inflammation paranasal sinuses and nose. It is worth paying attention to the quality and shape of the pillow for sleeping, it is best to use an orthopedic model. It is undesirable to allow damage to the nasal mucosa. Periodically, you need to moisturize it with oil solutions of vitamin A and E.

With frequent and seemingly unreasonable nasal bleeding, an examination by a hematologist, endocrinologist, and neurologist is mandatory. When taking drugs that change blood clotting, you should regularly monitor its performance. It is necessary to carry out annual prevention of acute respiratory viral infection, do not forget about hardening and vitamin therapy. And certainly one of the most important preventive measures is a consultation with a qualified ENT doctor.

Frequent nosebleeds are a common reason for visiting a doctor. In some cases, it even leads to hospitalization of the patient, especially if bleeding occurs after any injury. However, if there was a mechanical effect, there are no problems with making a diagnosis and prescribing treatment, but in other cases it is rather difficult to deal with the causes of the pathology. Why does the nose bleed, how dangerous is it, and what treatment can be prescribed for this condition?

There are many reasons for nosebleeds. The nasal cavity is well supplied with blood, the anterior nasal septum filled with blood vessels. Even a minor blow or any injury immediately leads to bleeding. At least once with this unpleasant phenomenon every person has encountered, but most often the blood itself stops after a while, and no more problems arise.

However, it is necessary to sound the alarm if nosebleeds began to occur without visible reasons, they are repeated and with great difficulty stop.

There are several common external causes:

• Solar and heat stroke. When the body overheats, dizziness, nausea are observed, a common symptom associated with an increase in blood pressure is nosebleeds. Overheating can be very dangerous, it is necessary to take the victim to a cool place as soon as possible and provide first aid.
• Intoxication, poisoning, exposure to various chemicals. Blood vessels mucous membranes are subjected to constant negative impact employees chemical industries, those who work with various volatile substances, etc. chronic poisoning leads to serious disorders in the body, manifested by frequent bleeding.
• Taking antihistamine drugs and some other drugs. Long-term use of aspirin can lead to bleeding - it helps to reduce clotting and thins the blood.

In addition to external causes, frequent nosebleeds can occur due to various infectious diseases. Among them are tuberculosis, syphilis, the condition of the mucosa is also negatively affected by diseases of the liver and kidneys. Blood often goes nose with high blood pressure: in this case, the patient feels tinnitus, dizziness, weakness.

Also frequent nosebleeds occur with increased fragility vessels, blood clotting disorders and other diseases of the circulatory system.

In any case, if frequent causeless bleeding is observed, it is necessary to undergo a full examination as soon as possible in order to identify and eliminate the cause.

First aid for nosebleeds

If nosebleeds have begun, it is important to properly provide first aid to the patient. Often people start to panic at the sight of blood - this further increases the pressure and only increases the bleeding. But if you know what to do, you can easily avoid unpleasant consequences for the body.

The person must be seated, providing peace. The head does not tilt back: blood must not enter the stomach, otherwise it may provoke vomiting. You can’t blow your nose when bleeding - this will not help the patient, and the blood will be more difficult to stop. The head should be slightly tilted forward, a cotton swab is placed in the nostril: it helps to form a plug and stop the bleeding.

A cold object should be applied to the area of ​​​​the bridge of the nose - this will help constrict the vessels, and the blood will stop faster.

If the patient is unconscious, he should be placed on his back with his head turned to the side to avoid blood entering the stomach. If first aid for nosebleeds does not work, you need to call an ambulance.

Useful video on how to properly stop a nosebleed.

When is it necessary to urgently call a doctor? Watch out for warning signs:

• Severe bleeding that does not stop for a long time. It is necessary to stop the bleeding as soon as possible, and for this you have to use medical help.
• The appearance of weakness, cold sweat, black dots before the eyes. As a rule, this condition is observed with severe blood loss, which must be stopped as soon as possible.
• General deterioration of well-being. Bleeding from the nose is just one of the symptoms that may indicate a serious illness.

Treatment

Treatment for nosebleeds depends on the cause. pathological condition. First of all, it is necessary to exclude the influence dangerous factors: mechanical and chemical influences, negative impact medicines, etc.

It is necessary to avoid overheating of the body, too intense physical exertion and other factors that can provoke bleeding. If it is not possible to immediately establish their cause, the doctor will prescribe a complete examination, based on the results of which treatment will be prescribed.

Depending on the identified cause, the doctor may choose one of the following methods of treating nosebleeds:

• If they are caused by (benign tumors) in the nasal cavity, surgery. The doctor will perform an operation and remove all formations from the nasal cavity, after which the bleeding will completely disappear.
• If bleeding occurs due to chronic or other inflammatory processes, the doctor will also prescribe special aerosols, treatment methods depend on the severity of the disease.
• If it is due to chemical damage, it is necessary to achieve complete elimination of the damaging factor, after which a diet is prescribed and special means with vitamins A and E. They contribute to more rapid healing and restoration of blood vessels.
• For bleeding due to long-term use blood thinners, the course of treatment has to be reviewed. Long term use such drugs pose a serious threat to human health: blood can come not only from the nose, serious internal bleeding with the unpredictable.
• If they are caused by any systemic diseases, will be assigned complex therapy. It is necessary not only to remove the symptom, but to eliminate the very cause of its occurrence - it can be an infection, allergic reaction, benign or malignant tumor etc. In all cases, after removing the cause, nosebleeds will disappear.

If a alarm symptom appeared at least a few times, it is necessary to start treatment. Bleeding from the nose is one of the first symptoms of such terrible diseases like cancer, diabetes mellitus, atherosclerosis, heart failure, etc. When frequent bleeding the doctor will prescribe drugs that increase blood clotting: these are Vikasol, chloride and calcium gluconate, as well as large doses vitamin C.

Surgery

In about 10% of cases, nosebleeds have to be stopped surgically.

The doctor may use one of the following techniques:

• Cauterization of a damaged vessel with a cotton swab dipped in a solution of silver nitrate. This procedure allows you to reliably stop the bleeding due to the formation of a crust.
• AT difficult cases coagulation of the vessel is prescribed: modern technologies make it possible to carry it out painlessly using a laser or electric current. Severe blood loss may even require a transfusion of plasma and donated blood.
• With local bleeding, solutions of lidocaine or novocaine can be injected directly into the mucosa. During surgical operation the doctor performs a cartilage resection and careful local intervention in the mucous membrane.
• Cryotherapy - freezing the damaged area with the help of liquid nitrogen. This technique avoids the appearance of scar tissue. In addition, it causes a minimum discomfort patient.

Modern technologies have expanded the capabilities of specialists: operations are carried out using the most gentle methods that do not require long recovery and allowing you to get a guaranteed result.

Possible Complications

Nosebleeds can be not only anterior, but also posterior: in the second case, blood begins to flow from rear wall nasal cavity, and in this case it is difficult to estimate the size of blood loss. If blood enters the stomach, it provokes vomiting with dark blood which will only make the patient feel worse. In this case, it is very difficult to stop the bleeding on your own, you need to call an ambulance and help the patient as soon as possible.

It is important to correctly identify the source of bleeding. If the blood bubbles, this indicates pathologies of the respiratory system, this condition requires immediate medical intervention. Foamed blood indicates pulmonary bleeding - it can lead to the most severe for the patient.

Intense bleeding leads to rapid blood loss: hemorrhagic shock occurs - a dangerous condition that can eventually lead to death.

Delay for the patient is extremely dangerous, if you cannot stop the blood on your own, you need to call an ambulance as soon as possible.